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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />�2 30 X�v;e� �u�, <br />PROJECT ADDRESS <br />�e�,; n G� �Q <br />Owner <br />Tenant <br />� , � <br />� .> :� �/e c �r, <br />Electncal Contractor <br />Mail ACdre: s <br />� ��� rei� <br />� � . <br />� G��in%c. f}r�:q�o,� <br />City <br />Mail Atldress <br />����� �����'� I Jl' �/��i� <br />Mail Address <br />L--�SC� f L�1' �% S 7 L 3 <br />State License Number <br />��.. ; <br />:,rs. � �,r� � l <br />Proposed Use ef Building <br />City <br />Sl�/J w�CTC�� <br />City <br />��� ��' l � � <br />Slate2ip Phone <br />SIatMZip <br />�l� �l��sz <br />State2ip <br />Phone <br />36U- (sz-��Yc� <br />Phone <br />�/GC��� <br />Contract Price of Work <br />_;: r��• !y'l�,c kw� �� <br />Contact Person (Plan Revi�w) <br />Descriotion of Work to Be Done: ��i�� �J �[1(.0 �� SC � �' � CL' � U <-���.9 <br />v <br />NOTE: WIRING IN NON-DWELLINGS IS R[QUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and ezamined fhis application and know the same to be true and <br />correct. All provisicns ellaws and ordinances goveming this type ol work will be completed <br />:vhefher speciried herein or noL The granling o/a perm!l dces not presume to give authcnty fo <br />violate or cancel the provisions ot any other siate er local la�v regulafing construction or fhr. <br />pedomtance o/ cons�ruction. i hat 1 am authcnzed by the owner o( this property to peAorm !he <br />�verk /or which application is made and I comply �wfh the State Confractors Law l8.27 RCW and <br />296.200 bVAC. . <br />�"��( �' '' i / " �� '-� �� -C � <br />�. <br />3i naWre n��o <br />FEE <br />� aC�o3- 098' <br />